NPIMap

Organization Active NPI

Aj Visiting Physicians Service Corporation

  • Adult Medicine Physician
  • Chicago, IL
National Provider Identifier
1417497033
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
036071319 Issued in IL
Legal business name
AJ VISITING PHYSICIANS SERVICE CORPORATION
Practice address
300 N State St
Suite 4124
Chicago, IL 60654-3036
Phone
(312) 670-0819
Fax
(312) 670-0829
NPI assigned
Mar 1, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Alicia R Joaquin, M.D.
Title
President
Phone
(312) 670-0819

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0505X 036071319 IL Primary

Addresses

Primary practice location

300 N State St
Suite 4124
Chicago, IL 60654-3036

Mailing address

300 N State St
Suite 4124
Chicago, IL 60654-5414
Phone (312) 670-0819

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493251200000",
    "number": "1417497033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N STATE ST",
            "address_2": "SUITE 4124",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606545414",
            "telephone_number": "312-670-0819",
            "fax_number": "312-670-0829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N STATE ST",
            "address_2": "SUITE 4124",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606543036",
            "telephone_number": "312-670-0819",
            "fax_number": "312-670-0829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AJ VISITING PHYSICIANS SERVICE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-01",
        "last_updated": "2017-04-27",
        "status": "A",
        "authorized_official_last_name": "JOAQUIN",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-670-0819",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "IL",
            "license": "036071319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.